Infant Behavior and Competence Following Prenatal Exposure to a Natural Disaster: The QF2011 Queensland Flood Study

This study utilized a natural disaster to investigate the effects of prenatal maternal stress (PNMS) arising from exposure to a severe flood on maternally reported infant social–emotional and behavioral outcomes at 16 months, along with potential moderation by infant sex and gestational timing of flood exposure. Women pregnant during the Queensland floods in January 2011 completed measures of flood‐related objective hardship and posttraumatic stress (PTS). At 16 months postpartum, mothers completed measures describing depressive symptoms and infant social–emotional and behavioral problems (n = 123) and competence (n = 125). Greater maternal PTS symptoms were associated with reduced infant competence. A sex difference in infant behavioral problems emerged at higher levels of maternal objective hardship and PTS; boys had significantly more behavioral problems than girls. Additionally, greater PTS was associated with more behavioral problems in boys; however, this effect was attenuated by adjustment for maternal depressive symptoms. No main effects or interactions with gestational timing were found. Findings highlight specificity in the relationships between PNMS components and infant outcomes and demonstrate that the effects of PNMS exposure on behavior may be evident as early as infancy. Implications for the support of families exposed to a natural disaster during pregnancy are discussed.     

The practical utility of the Welch Emotional Connection Screen for rating parent–infant relational health

Emotional Connection (EC) measured by the Welch Emotional Connection Screen (WECS) was related to the Parent–Infant Interaction Rating System (PIIRS), a 5‐point adaptation of the rating system developed for the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (e.g., NICHD Early Child Care Research Network, 1999, Developmental Psychology, 35, 1399). Parent–infant dyads (n = 49 mothers; 43 fathers) were videotaped during face‐to‐face interaction at infant age 6 months; interactions were coded with both the WECS and PIIRS. At age 3, mothers completed the Child Behavior Checklist. WECS ratings of EC were associated with PIIRS rating items for both mother–infant and father–infant dyads. Mother–infant EC related positively to maternal sensitivity and positive regard for child, child positive mood and sustained attention, and dyadic mutuality, and negatively with maternal intrusiveness. Father–infant EC related positively to fathers' positive regard for child, child positive mood and sustained attention, and dyadic mutuality. Mother–infant EC predicted child behavior problems at age 3 better than mother–infant PIIRS ratings of dyadic mutuality. With fathers, neither EC nor dyadic mutuality ratings predicted mother‐reported child behavior problems. Findings highlight the practical utility of the WECS for identifying potentially at‐risk dyads and supporting early relational health.     

Infants’ response to a mobile phone modified still‐face paradigm: Links to maternal behaviors and beliefs regarding technoference

Interruptions to parent–child interactions due to technology, or “technoference,” have been correlated with a host of negative child developmental outcomes. Yet, the influence of technoference on parent–infant interactions and infant behaviors has received less attention and more experimental work is warranted. For this study, parent–infant dyads (n = 227) completed a modified still‐face paradigm (SFP) using a mobile phone during the still‐face phase. Infant responses were coded for positive and negative affect, object and parent orientation, self‐comforting, and escape behaviors during the task. Results showed a robust still‐face effect, with infants displaying increased negative affect, decreased positive affect, increased self‐comforting, object orientation, and escape behaviors during the “still‐face” or phone distracted phase of the paradigm and frequently failing to return to baseline during the reunion phase. Older infants (older than 9 months) likewise demonstrated higher levels of negative affect across all three phases of the paradigm relative to younger infants (less than 9 months). Parent reports of technoference behavior were related to increased object orientation for younger infants. Parental technoference behaviors were also linked to more escape behaviors for younger infants and decreased object orientation in older infants during the still‐face portion of the SFP. Higher levels of technoference also appear to attenuate the negative emotional response of infants during still face. Results are discussed in relation to infants’ increasing exposure to digital technology in the context of early relationships.     

Costs of Not Getting to Know You: Lower Levels of Parental Reflective Functioning Confer Risk for Maternal Insensitivity and Insecure Infant Attachment

Parental reflective functioning (PRF) is a robust predictor of parenting sensitivity and secure infant attachment, but its assessment requires extensive resources, limiting its integration into research and clinical practice. The Mini‐Parent Reflective Functioning Interview (Mini‐PRFI) assesses the parent's capacity to mentalize for his/her 6‐month‐old infant (rated using the PRF coding system; Slade et al., 2004, PRF coding system and Slade REF, Unpublished protocol, New York, NY: The City University of New York). In the current study, we examined whether Mini‐PRFI scores were associated with theoretically related constructs; to establish a point of comparison, we evaluated links between Mini‐PRFI scores alongside RF assessed from the Adult Attachment Interview (AAI). Mother–infant dyads (N = 88) completed the AAI before the birth of the infant, the Mini‐PRFI and an interaction task (rated for insensitive parental behavior) when infants were 6 months old, as well as the Strange Situation Procedure when infants were 16 months old. Mini‐PRFI scores were strongly positively associated with AAI RF and negatively associated with maternal insensitivity. Mini‐PRFI scores predicted infant attachment organization (secure/insecure, organized/disorganized) at 16 months, and this effect was mediated by parenting insensitivity. These findings suggest that the Mini‐PRFI predicts theoretically related attachment constructs, demonstrating the promise of the Mini‐PRFI to increase the accessibility of interview‐based PRF measurements to clinicians and researchers.     

Maternal Into‐The‐Face Behavior,Shared Attention,and Infant Distress During Face‐to‐Face Play at 12 Months: Bi‐directional Contingencies

We describe a new maternal intrusion behavior, moving a toy or hand “into‐the‐face” of the infant, and we investigate its bi‐directional associations with infant‐initiated shared attention, infant distress, and infant gaze, during mother–infant face‐to‐face play at 12 months. The play was videotaped split‐screen, with infants seated in a high chair. Videotapes were coded on a 1‐sec time base for mother and infant gaze (at partner, toy, both, or gaze away); infant distress; and maternal intrusion behavior, “into‐the‐face.” We defined “infant‐initiated shared attention” as mother and infant looking in the same second at a toy that the infant‐initiated interest in. We documented that maternal into‐the‐face behavior decreased the likelihood of infant‐initiated shared attention, increased the likelihood of infant distress, and decreased the likelihood of infant gazing away. Reciprocally, infant distress and gazing away increased the likelihood of mother into‐the‐face. In moments when the dyad was engaged in infant‐initiated shared attention, mother into‐the‐face was less likely. This work documents bi‐directional contingencies in the regulation of maternal intrusion and infant behavior during face‐to‐face play at 12 months. We suggest that mother into‐the‐face behavior disturbs an aspect of the infant's experience of recognition.     

The Regulation of Infant Negative Emotions: The Role of Maternal Sensitivity and Infant‐Directed Speech Prosody

This study explored the role of maternal sensitivity and infant‐directed speech (IDS) prosody in infants’ expression and regulation of negative emotion. Seventy mothers and their 3‐month‐old infants were observed during the Still‐Face Paradigm (SFP). Maternal sensitivity and IDS prosody were assessed at baseline and infant negative affect in the baseline, still‐face, and reunion episodes. Results showed that prototypical IDS prosody characterized by wider fundamental frequency (F0) variability was related to decreases in infant's negative affect, but only if accompanied by maternal sensitivity. Infants of sensitive mothers who spoke with more prototypical IDS prosody showed better abilities to regulate negative affect during the SFP. When prototypical IDS prosody was accompanied by low maternal sensitivity, infants showed lower regulation of negative emotions. In conclusion, infant negative affect regulation in a dyadic setting is facilitated by an optimal combination of both more prototypical maternal IDS prosody and maternal sensitive responsiveness. Implications for the study of mother–infant interaction are discussed.     

Urgent engagement in 9/11 pregnant widows and their infants: Transmission of trauma

The potential effects of maternal trauma on mother–infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother–infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4–6 months. Split‐screen videotaped interaction was coded on a one‐second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self‐contingency and interactive contingency of behavior by time‐series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper‐contingent, high‐arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.     

Maternal Mentalization and Behavior Under Stressful Contexts: The Moderating Roles of Prematurity and Household Chaos

This study examines the links between online maternal mentalization during mother–infant interaction, maternal sensitivity, and family triadic interaction while considering the cumulative role of two stressful contexts (cumulative stressful contexts): premature birth (a child‐driven stressful context) and household chaos (an environment‐driven stressful context). Two moderation models were tested on a sample of 134 families with 6‐month‐old infants (77 low‐risk preterm, 57 full‐term). Cumulative stressful contexts mitigated the relations between maternal mentalization and behavior, such that online maternal mentalization during mother–infant interaction was related to both maternal sensitivity and the quality of family triadic interaction under low cumulative stressful contexts, but not under high cumulative stressful contexts. Implications for understanding the influence of online maternal mentalization on maternal sensitivity and the family triad are discussed.     

Predicting Patterns of Regulatory Behavior in the Still‐Face Paradigm at 3 Months

The current study addressed two aims: (1) to describe different patterns of infant regulatory behavior during the Face‐to‐Face Still‐Face (FFSF) paradigm at 3 months of age and (2) to identify specific, independent predictors of these patterns from an a priori set of demographic, infant (e.g., temperament), and maternal (e.g., sensitivity) variables. Analyses were based on data collected for 121 mother–infant dyads assessed longitudinally in the newborn period and again at 3 months. In the newborn period, infants’ neurobehavior was evaluated using the Neonatal Behavioral Assessment Scale (NBAS) and mothers reported on their caregiving confidence and their newborns’ irritability and alertness. At 3 months, mothers reported on their infant's temperament, and mother–infant interactions were videotaped during free play and the FFSF. Three patterns of infant regulatory behavior were observed. The most common was a Social‐Positive Oriented Pattern, followed by a Distressed‐Inconsolable Pattern, and a Self‐Comfort Oriented Pattern. Results of multinomial logistic regression indicated that categorical assignment was not associated with demographic or infant characteristics, but rather with dyadic regulatory processes in which maternal reparatory sensitivity played a crucial role.     

Maternal prenatal mood problems and lower maternal emotional availability associated with lower quality of child's emotional availability and higher negative affect during still-face procedure

Our aim was to study the effects of maternal perinatal mood and maternal emotional availability on child emotional availability and negative affect during the still-face procedure (SFP). The sample included 214 women who participated in a prospective study. We assessed maternal mood problems using the Mini International Neuropsychiatric Interview and PRAQ questionnaire during pregnancy and using STAI and EPDS questionnaires during pregnancy and at 6 months after delivery. Maternal and child emotional availability were studied using the Emotional Availability Scales during the SFP at 6 months. We observed and quantified child's negative affect during SFP episodes. We found that mothers with maternal mood problems (anxiety and/or depression) during pregnancy, but not postnatally, showed less optimal maternal structuring during the SFP, and the children showed lower involvement and responsiveness during interactions with their mothers. Furthermore, lower maternal emotional availability was related to the child's higher negative affect during the SFP. Our findings underline the independent roles of both prenatal stress exposure and maternal caregiving behavior in a child's socioemotional development.     

Maternal Lifetime Trauma Exposure,Prenatal Cortisol,and Infant Negative Affectivity

Little research has examined the impact of maternal lifetime trauma exposure on infant temperament. We examined associations between maternal trauma history and infant negative affectivity and modification by prenatal cortisol exposure in a sociodemographically diverse sample of mother–infant dyads. During pregnancy, mothers completed measures of lifetime trauma exposure and current stressors. Third‐trimester cortisol output was assessed from maternal hair. When infants were 6 months old, mothers completed the Infant Behavior Questionnaire‐Revised. In analyses that controlled for infant sex and maternal age, education, race/ethnicity, and stress during pregnancy, greater maternal trauma exposure was associated with increased infant distress to limitations and sadness. Higher and lower prenatal cortisol exposure modified the magnitude and direction of association between maternal trauma history and infant rate of recovery from arousal. The association between maternal trauma history and infant distress to limitations was somewhat stronger among infants exposed to higher levels of prenatal cortisol. The analyses suggested that maternal lifetime trauma exposure is associated with several domains of infant negative affectivity independently of maternal stress exposures during pregnancy and that some of these associations may be modified by prenatal cortisol exposure. The findings have implications for understanding the intergenerational impact of trauma exposure on child developmental outcomes.     

Patterns of positivity: Positive affect trajectories among infants of mothers with a history of depression

This study examined positive affect (PA) trajectories over the first year of life among infants of mothers with a history of depression (N = 191) as well as predictors (i.e., maternal prenatal and postpartum depression symptoms, maternal parenting behaviors) of those trajectories. Infant PA was observed in play and feeding tasks during laboratory visits at 3, 6, and 12 months of age; parenting behaviors were observed at 3 months. Mothers completed questionnaires regarding their symptoms of depression throughout the prenatal period and during the first 3 months postpartum. Growth curve analyses indicated that infant PA increased across time, and this finding replicated across both the play and feeding tasks, though increases slowed over time. Neither maternal prenatal nor postpartum depression symptoms predicted infants' PA trajectories, but mothers' PA, positive parenting, and disengaged parenting were associated with infant PA during the play task. Our finding that infant PA increased over the first year postpartum suggests PA trajectories among infants of mothers with a history of depression may be indices of resilience, despite risks associated with their mothers' history of depression. Furthermore, this study highlights parenting behaviors that may be important targets of prevention and early intervention efforts to bolster infant PA.     

Infant Sex Moderates the Effects of Maternal Pre‐ and Postnatal Stress on Executive Functioning at 8 Months of Age

Previous studies report that early life stress, including maternal pre‐ and postnatal stress, has adverse effects on cognitive development and that these associations might be sex‐specific. However, no studies exist on early life stress and infant executive functioning (EF). The aim of this study was to examine the relationship between maternal pre‐ and postnatal stress and infant EF, and whether these associations are moderated by infant sex. Maternal prenatal depressive, general anxiety, and pregnancy‐specific anxiety symptoms were measured three times, and postnatal depressive and general anxiety symptoms were measured 6 months postpartum. Infant EF was assessed with a modified A‐not‐B task 8 months postpartum (N = 214). Maternal postnatal general anxiety predicted poorer EF in girls in comparison with boys. Moreover, there was a trend toward an interaction between prenatal anxiety and infant sex such that prenatal anxiety predicted infant EF differently in girls and in boys. No association was found between depressive symptoms or pregnancy‐specific anxiety symptoms and infant EF. These findings suggest that maternal anxiety may have sex‐specific effects on early EF and that pre‐ and postnatal stress may differently affect infant EF/cognitive development. The implications of these findings and important future directions are discussed.     

Prenatal Depression and Infant Temperament: The Moderating Role of Placental Gene Expression

Prior research has demonstrated the link between maternal depression during pregnancy (i.e., prenatal depression) and increased neurodevelopmental dysregulation in offspring. However, little is known about the roles of key hypothalamic–pituitary axis regulatory genes in the placenta modulating this association. This study will examine whether placental gene expression levels of 11β‐hydroxysteroid dehydrogenase type 2 (HSD11B2), glucocorticoid receptor (NR3C1), and mineralocorticoid receptor (NR3C2) can help elucidate the underlying mechanisms linking prenatal depression to infant temperament, particularly in infants with high negativity and low emotion regulation. Stored placenta tissues (N = 153) were used to quantify messenger ribonucleic acid levels of HSD11B2, NR3C1, and NR3C2. Assessments of prenatal depression and infant temperament at 6 months of age were ascertained via maternal report. Results found that prenatal depression was associated with increased Negative Affectivity (p < .05) after controlling for postnatal depression and psychosocial characteristics. Furthermore, the association between prenatal depression and Negative Affectivity was moderated by gene expression levels of HSD11B2, NR3C1, and NR3C2 such that greater gene expression significantly lessened the association between prenatal depression and Negative Affectivity. Our findings suggest that individual differences in placental gene expression may be used as an early marker of susceptibility or resilience to prenatal adversity.     

Does Child Sex Moderate Vulnerability to Postpartum Risk among Infants of Mothers at Risk for Psychopathology?

Early childhood behavior problems may indicate risk for subsequent psychopathology (Shaw, Gilliom, Ingoldsby, & Nagin, Developmental Psychology, 39, 2003, 189). There is some evidence to suggest that boys and girls may be differentially susceptible to postpartum risk factors that predict problem behaviors in early childhood (Kochanska, Coy, & Murray, Child Development, 72, 2001, 1091; Martel, Klump, Nigg, Breedlove, & Sisk, Hormones and Behavior , 55, 2009, 465). The main aim of this study is to examine whether child sex moderates the effect of infant and maternal predictors of toddler problem behaviors in a unique sample of high‐risk mother–child dyads. Analyses were based on data collected for 198 mother–child dyads (52% male offspring) followed longitudinally from birth to 18 months. Maternal and infant variables, including maternal PTSD and depression symptoms, maternal maltreatment history, observed maternal parenting quality, demographic risk, and infant negative emotionality and night waking, were used to predict toddler behavior problems. Although boys and girls displayed similar levels of total problem behaviors at 18 months overall, the specific set of infant and maternal variables that predicted toddler problems varied by child sex. The significant predictor for boys was maternal PTSD symptoms, whereas significant predictors for girls were infant negative emotionality and sleep problems. Results suggest that sex‐differentiated transmission of risk can be identified as early as 18 months postpartum. These differences suggest a gender‐specific biological sensitivity to maternal psychopathology, or alternatively, a gender‐specific reporting bias among mothers with childhood maltreatment histories.     

Maternal Postpartum Depression Increases Vulnerability for Toddler Behavior Problems through Infant Cortisol Reactivity

The current study examined the role of hypothalamic‐pituitary‐adrenal reactivity (a physiological indicator of stress) in early infancy as a mediator of the relationship between maternal postpartum depression and toddler behavior problems. Participants were 137 at‐risk mothers and their children participating in a longitudinal study of intergenerational transmission of risk. Mothers’ depression was measured five times during the infants’ first 18 months. Infant cortisol was collected during a social stressor (the still‐face paradigm) when infants were 6 months old, and mothers reported on toddlers’ internalizing and externalizing symptoms at 18 months. Among this sample of high‐risk mother–infant dyads, early postpartum depression predicted atypical infant cortisol reactivity at 6 months, which mediated the effect of maternal depression on increased toddler behavior problems. Clinical implications are discussed.     

Relation Between Maternal Contingent Responsiveness and Infant Social Expectations

This study investigated the relation between maternal contingent responsiveness and 4‐ and 5‐month‐old infants' (N = 64) social expectation behavior in a still‐face procedure. Mothers were asked to interact with their infants for 2 min (interactive phase), remain still‐faced for 1 min (still‐face phase), and resume interaction for 2 min. Mother and infant behavior was assessed for the frequency of infant and mother smiles, mother smiles that were contingent to infant smiles and infant smiles were contingent to mother smiles during the interactive phase, and infant social bids to mother during the still‐face phase. Hierarchical regression showed that mother contingent smiles during the interactive phase accounted for unique variance in infant social bids during the still‐face phase beyond that accounted for by the frequency of mother and infant smiles during the interactive phase. These results support the view that young infants' social expectations and sense of self‐efficacy are formed within their interactions with their caregivers.     

Predisposing Factors for Elevated Restricted and Repetitive Behavior in Typically Developing Toddlers

Little is known about the relation between levels of restricted and repetitive behavior (RRB) in infants and parent factors. The present study investigated maternal and psychosocial factors (depressive symptoms, socio‐economic status, social support) and mother–infant engagement factors (mind‐mindedness, sensitivity, and infant–mother attachment security) as predictors of children's RRB at age 26 months in a sample of 206 mothers and children. Maternal depressive symptoms predicted levels of sensory and motor repetitive behavior and rigid, routinized, and ritualistic repetitive behavior. Lower socioeconomic status also predicted independent variance in children's sensory and motor repetitive behavior. The relations between maternal depressive symptoms and both types of RRB were not mediated through observational measures of maternal sensitivity or mind‐mindedness at 8 months, or attachment security at 15 months. The results are discussed in terms of whether stress regulation, self‐stimulation, and genetic susceptibility can help explain the observed link between maternal depressive symptoms and RRB in the child.     

Infant Neurodevelopment is Affected by Prenatal Maternal Stress: The QF2011 Queensland Flood Study

Research shows that prenatal maternal stress (PNMS) negatively affects a range of infant outcomes; yet no single study has explored the effects of stress in pregnancy from a natural disaster on multiple aspects of infant neurodevelopment. This study examined the effects of flood‐related stress in pregnancy on 6‐month‐olds' neurodevelopment and examined the moderating effects of timing of the stressor in gestation and infant sex on these outcomes. Women exposed to the 2011 Queensland (Australia) floods in pregnancy completed surveys on their flood‐related objective and subjective experiences at recruitment and reported on their infants' neurodevelopment on the problem solving, communication, and personal–social scales of the Ages and Stages‐III at 6 months postpartum (N = 115). Interaction results showed that subjective flood stress in pregnancy had significantly different effects in boys and girls, and that at high levels of stress girls had significantly lower problem solving scores than boys. Timing of the flood later in pregnancy predicted lower personal–social scores in the sample, and there was a trend (p < .10) for greater objective flood exposure to predict lower scores. PNMS had no effect on infants' communication skills. In conclusion, differential aspects of maternal flood‐related stress in pregnancy influenced aspects of 6‐month‐olds' neurodevelopment.     

The Quality of Spontaneous Movements of Preterm Infants: Associations with the Quality of Mother–Infant Interaction

The assessment of the quality of infants’ spontaneous movements is a diagnostic tool for the young nervous system. We examined whether it relates to the quality of the interactions between infants born preterm and their mothers. Thirty‐nine healthy infants born preterm (M_{age in weeks} = 14.59, SD = 2.21; 38.46% female) and their mothers participated in the study. Infants’ quality of spontaneous movements was assessed using the General Movement Assessment according to Prechtl (Prechtl, Early Human Development 1990, 23, 151). A new measurement was employed to evaluate the following aspects of the mother–infant interaction: maternal sensitivity in the motor modality (i.e., when touching, picking up, holding, and putting down the infant), maternal sensitivity in the modalities of vocalization and eye contact, and infants’ positive engagement. Several aspects of infants’ quality of movements were associated with maternal sensitivity in the motor modality and infants’ positive engagement, but not with maternal sensitivity in the modalities of vocalization and eye contact. These findings suggest that the quality of infants’ spontaneous movements may explain some of the variability in the interactions between infants born preterm and their mothers. The results also highlight the importance of differentiating between the modalities of mothers’ behavior when assessing their sensitivity. Implications for research and practice with families of preterm infants are discussed.